High Levels of Oestrogen in Utero May Cause PCOS

Anne Seccombe

“We propose that in utero exposure to excessive levels of steroids such as estrogen has a long-term effect on the ability of the thymus to produce regulatory T cells. In female offspring this can lead to PCOS.”

Researchers from Binghamton University in New York published an article on 18 May 2009 in the Journal of Reproductive Biology and Endocrinology hypothesizing a new cause for PCOS.

Essentially they suggest, and their study supports, the theory that exposure of a foetus to high levels of steroids (such as eostrogen, testosterone or corticosteroids) whilst it is in utero may cause a cascade of auto-immune dysfunctions involving the thymus gland and it’s production of regulatory T-cells, eventually resulting in polycystic ovarian syndrome if the child is female. Sources of steroid exposure are likely to be from dietary phytoestrogens in the case of oestrogen or severe maternal stress whilst pregnant in the case of corticosteroids.

In the study, mice were injected with oestrogen at between 5 & 7 days old. This is known to cause anovulation and follicular cysts, a disease model that bears a similarity to PCOS in humans.

It is generally believed (but not proven) that this response is due to the hypothalamus responding to the excess oestrogen and a disruption in the GnRH delivery system.

This group of researchers, however, had a new idea which they sought to prove, namely that the anovulation and follicular cysts may be part of an immune response to the oestrogen and involving the thymus gland and it’s production of a specialised type of white blood cells called T cells and which help to fight infection or potential infection and also have a regulatory effect. High levels of oestrogen appear to prevent the thymus gland from producing fully developed regulatory T-cells. The absence of T-regulatory cells is known to cause a number of auto-immune diseases.

The researchers found that mice who had their thymus gland removed when they were 3 days old, prior to the injection of oestrogen, they did not develop follicular cysts and anovulation. When these mice later received an infusion from older mice who had been exposed to oestrogen, they found that the disease was transferable in a large percentage of the mice through the lymphocytes. Thus it would appear that the absence of regulatory T-cells is a prerequisite for the formation of follicular cysts.

The researchers concluded that exposure in utero to steroid hormones such as oestrogen or testosterone are unlikely to be derived from the mothers’ own hormones as these are usually only present in nanogram levels, whereas milligram levels are required to produce these effects. Therefore, the researchers hypothesize that it is more likely that these levels are achieved through the ingestion of phytoestrogens from the mothers’ diet, such as are found in soy and flaxseed products. Although it wasn’t covered in depth in the present study, the researchers highlighted that severe stress in pregnancy would raise levels of corticosteroids which are also known to negatively affect the spleen and thymus development of a foetus and the subsequent production of lymphocytes/thymocytes respectively.

Thymus Gland of a Newborn (Gray's Anatomy)

The thymus gland is located just behind the top of the sternum or breastbone, below the thyroid gland and acts as a nursery where lymphocyte precursors which are produced in the bone marrow are taken out of the blood into the thymus gland, where they mature into thymocytes and eventually T-cells. Once they are mature, the T-cells are released back out into the blood stream where they have a complex function in regulating the immune system.

The thymus gland is an interesting one, in that it is most active during childhood developing to it’s peak until puberty, where it stops developing and starts to atrophy. When a child is born, the thymus gland is pinkish-grey in colour and lobulated (it has a bumpy surface, somewhat like the brain). It weighs about 15 grams at birth and is about 5 cm long, 4 cm wide and 6 mm deep. It is separated into two lobes, so it looks something like a butterfly drawn by a 2 year old. By the time a child reaches puberty the thymus gland has grown to about 35 grams in weight and has developed all the T-lymphocytes it will need to last a lifetime. By the time an adult reaches their seventies, the gland has degenerated into fatty islands which are almost indistinguishable from the surrounding tissue and have turned yellow in colour. It will now weigh only about 5 grams; a third of it’s weight at birth, and less than 15 % of it’s peak weight at puberty.

Could this idea be extended to include exposure to steroids early in life? I was on high doses of steroids for over 6 months, before I turned 2 years old. I gained huge amounts of weight and was sent from nutritionist to nutritionist my entire childhood. It wasn’t until I was a teenager I was finally diagnosed with PCOS and the most severe insulin resistance my endocrinologist had ever seen.

It’s not inconceivable. Certainly steroids have a very negative effect on insulin sensitivity, as any diabetic who has been put on oral steroids for arthritis etc could tell you. Even a small dose can triple or quadruple insulin requirements.

It is entirely possible, and in fact highly likely, that your steroid use as a young child damaged your ability to respond to the hormone insulin. Steroids are well know to impair insulin sensitivity and cause weight gain.

Have you managed to get things under control now? Do you use insulin sensitising agents such as d-chiro inositol, cinnamon, green tea, gymnema, chromium, vanadium, magnesium and manganese? Or the drug metformin?

Have you looked into the research behind DCI and PCOS? I’ve attached a little information on it for you. There’s also some information on DCI on my other website: How does D-chiro inositol work/

My Doctors have told me that I have had PCOS for the last twenty something years. I am having so much trouble now I am in my mid forties losing the weight that I need to lose. Does anyone have any idea to help me I am just about to try the low carb diet. So any information would be helpful. I wasn’t able to keep any of my babies that I feel pregnant with but I did notice when I was on IVF that the PCOS seem to not be there. So any information about this would be a help as well.

A controlled carbohydrate diet is an integral part of any successful PCOS treatment plan. In fact, in combination with regular exercise, a controlled carbohydrate diet has been found to be more effective than the drug metformin in the treatment of PCOS.

If you have any questions, or there’s anything else I can help you with, please let me know.

I have just read your proposal and find it so positive that someone is researching pcos, I got diagnosed with borderline pcos about 3 years ago however I’m stick thin and only suffer from hirtuism quite bad! I am convinced that I do not have pcos because the hair growth came out of no where in my late 20’s my periods have got a little worse however I’m still quite regular I guess, however I think like the tested mice, I feel somewhat similar that there is a replica of pcos, with almost similar symptoms however being in the U.K you jus get diagnosed with presumed as the NHS jus won’t investigate this further

Thank you for this research. The corticosteroid links makes a lot of sense in the context of premature birth increasing the risk of PCOS. Standard protocol from the 1980’s onwards was/is to treat mothers in prem labour with steroids to precipitate lung development in the foetus. It also makes sense as to why clusters of inflammatory problems can be seen. In my case I have been variously diagnosed with IBD/PCOS/endometriosis. All which I am treating with a combination of traditional medication and supplementation but which I am working hard to understand the root cause of, which intuition has always told me is linked. That, along with depression and anxiety.

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